Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 25567363 · doi:10.1186/s12916-014-0182-6
What was done
Authors systematically searched literature up to August 2014 using PRISMA guidelines to evaluate the relationship between alcohol consumption, drinking patterns, and ischemic heart disease (IHD) risk compared with lifetime abstainers. They performed a narrative review of existing meta-analyses from the preceding 10 years and conducted a quantitative meta-analysis evaluating the impact of episodic heavy drinking among average moderate drinkers.
What was found
Average alcohol consumption showed a J-shaped relationship with IHD compared to lifetime abstainers (elevated risk among smokers was noted as an exception). Individuals with alcohol use disorder had a 1.5- to 2-fold elevated risk of IHD. In quantitative meta-analysis, drinkers with an average intake of <30 g/day and no episodic heavy drinking had lower IHD risk (relative risk = 0.64, 95% CI 0.53 to 0.71). Drinkers with episodic heavy drinking occasions had an IHD risk comparable to lifetime abstainers (relative risk = 1.12, 95% CI 0.91 to 1.37).
Why it matters
Assessing average alcohol consumption alone is insufficient to evaluate cardiovascular risk because heavy drinking episodes negate the lower IHD risk associated with moderate daily intake.
Limits
The abstract does not state the number of studies or total participant count included in the meta-analyses. Findings are derived from observational studies subject to self-report inaccuracies regarding drinking patterns and potential residual confounding.
Cited by
- supports When former drinkers are removed from the non-drinker category, alcohol intake just below one US standard drink per day is associated with a 17% to 18% lower relative risk of ischemic heart disease compared to non-drinkers.